DOI: 10.36347/sasjm.2022.v08i07.010

Pages: 480-488

Background: Bleeding varices is a common complication of portal hypertension. It occurs secondary to schistosomal portal hypertension in the majority of our patients. The aim of this study is to determine the factors possibly affecting risk of recurrent variceal bleeding. Methods: This study is a descriptive cross sectional hospital based study which was carried out in Ibn Sina Specialized Hospital Bleeding Center during the period from July 2019 to January 2020. A total of 201 (n= 201) patients suffering from bleeding varices due to schistosomal portal hypertension were included. Any patients bleeding from other causes were excluded. Baseline laboratory investigations were done (CBC, RFT, and INR). Patients underwent upper GI endoscopy. Results: Males were predominant (78.6 %, n= 158), while 21.4 % of patients were females (n=43). Male: Female ratio was 4:1. Age ranged from > 20 to < 70 years, mean age being (52.15 ± 15.7) years. At presentation 44.7% of patients (n= 90) had both hematemesis and melena, 28.8% of patients (n= 46) had only melena and 32.2% (n= 65) had only hematemesis. Forty three percent of patients (n= 87) had Hemoglobin of less than 8 g/dl. Comorbidities were present in 19.9 %. Previous attacks of hematemesis were found in (88.6%) of patients (n= 178) and previous attacks of melena were found in 56.7% (n= 114). Endoscopy showed grade 3 esophageal varices in 50.7% (n= 102). Band ligation was done to 48.9 % (n= 97), while 29.4 % (n= 59) received sclerotherapy. One hundred and twenty two patients (60.7%) recovered and discharged from the hospital after one day and 38.3% (n= 77) stayed for more than 2 days. Unfortunately 7 Patients expired (3.5%). The correlations between the occurrence of re-bleeding and the level of hemoglobin at presentation (P= 0.014), grade of the varices, chronicity of schistosomiasis (P= 0.03 for both) and hypertension (P= 0.04) were statistically significant. Smoking was significantly associated with risk of re-bleeding (P=.05